As “Captain Obvious” has said, “There seems to be some
changes coming our way”. The problem
that the Captain has ignored is we aren’t really sure what those changes will
be and how they will affect our agencies and clients.
It’s been said that the potential for change in our market
is there, but until contracts are signed, you really don’t know how to prepare.
With that being said, the truth is you do need to
prepare. If you don’t, you’ll find
yourself falling behind in an already competitive marketplace.
When you cut through all the noise, common sense can help
guide your preparation.
Invest in technology
infrastructure – The move to managed care has put increasing pressure on
provider organization to collect, manage, share, and analyze data for
population health management and value-based contracts. The expectation for provider organizations to
offer consumer portals and monitor staff improvements will also come into
As an example, the medical/hospital world has moved to this
model. It’s only logical that I/DD and
Mental Health follow suit.
Technology is not just an EHR data repository. The idea of integrating your entire agency’s
back office functionality with your clinical data is the model hospitals have
been using successfully for years.
Adjust revenue cycle
management practice – Provider organizations must be able to provide
detailed documentation of services provided, as well as accurate claims. The
old fee-for-service (FFS) billing skills are of no use in a managed care
environment. Preparing may mean training, it may mean outsourcing, or it may
mean completely replacing your current system and staff.
The challenges to a transition to managed care are
especially focused on claims and billing processing. An integrated platform can alleviate those
culture – You should realize that jobs and responsibilities within the
organization may be altered or changed dramatically. Leadership should be
prepared for these changes and a focused approached to staff education and
preparation for change will be key to your continued success.
Invest in the future – The specifics of the future may be murky right now. However by making the investment of preparation, your agency will be ready to prosper in the “new normal” rather than trying to catch those that have.